Extraordinary Large Giant Congenital Melanocytic Nevus Treated with Integra Dermal Regeneration Template

Tønseth, Kim Alexander; Filip, Charles; Hermann, Robert Michael; Vindenes, Harald; Høgevold, Hans Erik

doi:10.1097/gox.0000000000000454

Cited by 8 publications

(4 citation statements)

References 8 publications

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“…Table 1 presents the characteristics of the studies that were included in the analysis. Almost all the reported cases were case reports, accounting for 54.8% of the patients [4, 9–16, 18, 19]. Of the remaining studies, one was retrospective [17] and one study was a prospective study [8].…”

Section: Resultsmentioning

confidence: 99%

Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases

Opoku-Agyeman

Humenansky

Davis

et al. 2019

Surgery Research and Practice

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Background The use of Integra Dermal Reconstruction Template has emerged as an option for wound reconstruction, after resection of congenital nevi, especially giant congenital nevi. There have been many reports on Integra use in the literature for this purpose. This systematic review with pooled analysis examines the current literature regarding Integra use after resection of congenital nevi, including patient characteristics and reported outcomes. Methods Systematic electronic searches were performed using PubMed, Ovid, Embase, and Cochrane library databases for studies reporting the use of Integra to reconstruct defects after nevi resection. Studies were analyzed if they met the inclusion criteria. Pooled descriptive statistics were performed. Results Thirteen studies that met the inclusion criteria were included for analysis, yielding 31 procedures in 31 patients. Eleven of the thirteen studies were case reports representing 17 of the 31 patients. One study was retrospective, and the other study was a prospective study. The mean follow-up was 2.67 years (range, 0.2–13 years). The overall wound closure rate was 100%. The overall initial Integra take rate was 90.3% and the skin graft take rate was 100%. The rate of reported complications was 14.8%. The average age of patients was 7.36 years. The average size of the nevus was 6.29% TBSA (range, 0.005%–26%), and the time to definitive skin grafting was 3.28 weeks. Significant heterogeneity was found among the published studies. Conclusion We conclude that the use of Integra appears to be a safe and viable option for defect reconstruction after the primary or secondary excision of congenital nevi of different sizes and on most parts of the body. Long-term follow-up studies and prospective cohort studies are required in order to fully estimate the incidence of complications. However, the rarity of this condition make these types of studies very difficult.

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Section: Resultsmentioning

confidence: 99%

Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases

Opoku-Agyeman

Humenansky

Davis

et al. 2019

Surgery Research and Practice

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“…24 Nevertheless, the use of allogeneic split thickness skin grafts may still have a role in garment-like giant congenital nevi, where there is deficient available donor skin for grafting and dermal substitutes serve as a scaffold for coverage with a split thickness skin graft. 61,62 Tissue expanders create a highly versatile piece of tissue that can be utilized not only as an expanded full thickness skin graft, but also as an expanded advancement, rotation, transposition, or free flap. 13 Tissue expansion is typically performed over a 3-to 6-month interval prior to excision of the lesion, with weekly inflations that may be performed at home if proper teaching, anticipatory guidance, and psychological support are provided.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Giant Congenital Melanocytic Nevi of the Head and Neck: Clinical Update and Advances in Treatment

Applebaum

Weissman

Chwa

et al. 2022

FACE

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Introduction: Giant congenital melanocytic nevi are rare lesions of various size, shape, color, and location with potential complications including malignant and neurocutaneous melanoma. Here we discuss the etiology and epidemiology of giant congenital melanocytic nevi, the indications and options for treatment, and current data regarding outcomes, as well as our preferred approach to patient management. Methods: Full text case reports, retrospective studies, prospective studies, clinical trials, and review articles regarding giant congenital melanocytic nevi in English were included in this analysis utilizing PubMed, MEDLINE, EMBASE, and Google scholar databases. Results: Giant congenital melanocytic nevi pose a difficult diagnostic and reconstructive challenge for the plastic surgeon. Indications for treatment depend on the size of the nevus, pigmentation, established melanoma, persistent symptoms, maintenance of function, and psychological burden. A multidisciplinary approach should be applied to establish an individualized treatment plan for patients with giant congenital melanocytic nevi. Numerous surgical and nonexcisional options have been illustrated for the management of these lesions. Chemical peels and laser ablation are among the most common non-surgical approaches. When considering surgical treatment for lesions with malignant potential, a multimodal approach is generally employed, including serial excision, excision with skin grafting and/or skin substitutes, and tissue expansion. Conclusion: A proper understanding of the disease’s histology, natural history, complications, and treatment options are essential in the management of these complex lesions.

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“…Giant CMN (GCMN) with a diameter greater than 20 cm have an estimated incidence of between 1/20,000 and 1/500,000 births. The risk of transformation of GCMN to malignant melanoma varies between 0 and 3.8% [ 3 ]. Besides malignant transformation, patients with GCMN need to be periodically assessed for neurological abnormalities and psychosocial impairment.…”

Section: Introductionmentioning

confidence: 99%

Giant Congenital Melanocytic Nevi: An Update and Emerging Therapies

2018

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Giant congenital melanocytic nevi (GCMN) are a rare occurrence. Gain-of-function mutation in the NRAS gene is found to be associated with GCMN, causing abnormal proliferation of embryonic melanoblasts. The two major complications associated with GCMN are malignant melanoma and neurocutaneous melanosis. Treatment of GCMN has conventionally been surgical. However, the role of NRAS inhibitors and inactivation of nevus tissue by high hydrostatic pressure are being explored. We present a case of a 1-day-old neonate born with GCMN, along with a review of the literature.

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Extraordinary Large Giant Congenital Melanocytic Nevus Treated with Integra Dermal Regeneration Template

Cited by 8 publications

References 8 publications

Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases

Use of Integra for Reconstruction after Nevi Resection: A Systematic Review and Pooled Analysis of Reported Cases

Giant Congenital Melanocytic Nevi of the Head and Neck: Clinical Update and Advances in Treatment

Giant Congenital Melanocytic Nevi: An Update and Emerging Therapies

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